This is a proposal to incorporate a treatment component into the current World Trade Center (WTC) Screening and Monitoring program at Bellevue Hospital / New York University (NYU) School of Medicine. The WTC monitoring program, established in 2002, consists of a group of occupational medicine clinics that provide comprehensive medical screening, referrals and benefits counseling to workers affected by the events on and after 9-11. The NYU / Bellevue program was originally proposed in 2002 as a collaboration between New York University / Bellevue Hospital and diverse organizations including the Fraternal Order of Police, the Metal Trades Department, and community organizations such as the Latin American Workers Project and the Beyond Ground Zero network. We will continue to work with these organizations while extending our outreach efforts to include workers and volunteers from other unions and community organizations throughout New York City. The Bellevue / NYU program has developed a strong collaboration among the Division of Pulmonary and Critical Care Medicine, the Bellevue/NYU Occupational and Environmental Medicine Clinic, and the NYU/Bellevue Department of Psychiatry. The initial evaluations have revealed prevalence of respiratory and mental health conditions. We will continue this screening and monitoring program and propose to add a treatment component to the program. We anticipate that offering an integrated comprehensive screening, monitoring, and treatment program will increase the number of referrals to our program and improve our retention rate. Physicians in our program are sensitive to the needs of the WTC rescue workers. This comprehensive program will also heighten the sensitivity of large numbers of other Bellevue and outside physicians to the ongoing needs and emerging disease trends of this patient population. The proposed program, utilizing a mix of pulmonary and occupational medicine specialists, general internists, and nurses, supported by a psychologist, social worker, and medical assistants, will offer much improved continuity and coordination of clinical care and long term follow-up of this group of patients. [unreadable] [unreadable] [unreadable] [unreadable]